Individual provider Active NPI

Zipora Herzberg, PSY.D.

  • Clinical Psychologist
  • Lawrence, NY
National Provider Identifier
1477533420
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8589 Issued in NY
Practice address
30 Westover PL
Lawrence, NY 11559-1730
Phone
(516) 239-6770
Fax
(516) 239-6770
NPI assigned
Jan 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 8589 NY
Psychologist 103T00000X 8589 NY
Adult Development & Aging Psychologist 103TA0700X 8589 NY
Clinical Psychologist 103TC0700X 8589 NY Primary
Clinical Child & Adolescent Psychologist 103TC2200X 8589 NY
Family Psychologist 103TF0000X 8589 NY
Forensic Psychologist 103TF0200X 8589 NY
Health Service Psychologist 103TH0100X 8589 NY
Intellectual & Developmental Disabilities Psychologist 103TM1800X 8589 NY
Psychologist 103T00000X 85889 NY
Rehabilitation Psychologist 103TR0400X 8589 NY
School Psychologist 103TS0200X 8589 NY

Addresses

Primary practice location

30 Westover PL
Lawrence, NY 11559-1730

Mailing address

30 Westover PL
Lawrence, NY 11559-1730
Phone (516) 239-6770

Other identifiers 1

IdentifierTypeStateIssuer
01584803MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050126000074 NY Practitioner - Clinical Psychologist 4789634981 Practice locations: Lawrence, NY; Far Rockaway, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

30 Westover PL
Lawrence, NY 11559-1730
Phone (516) 239-6770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
85889NYMDPsychologist
8589NYMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1477533420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WESTOVER PL",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591730",
            "telephone_number": "516-239-6770",
            "fax_number": "516-239-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 WESTOVER PL",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591730",
            "telephone_number": "516-239-6770",
            "fax_number": "516-239-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZBERG",
        "first_name": "ZIPORA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "8589",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "8589",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NY",
            "license": "8589",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "8589",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "8589",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "NY",
            "license": "8589",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "NY",
            "license": "8589",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "NY",
            "license": "8589",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NY",
            "license": "8589",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "85889",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "NY",
            "license": "8589",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": "8589",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01584803",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, NY

Sources for this page

Verify at the official NPI Registry.